Sclerotheraphy for Esophageal Varices: A Retrospective Study of 61 Patients Treated at King Faisal Specialist Hospital

Abstract

Over a period of 36 months, 61 patients underwent sclerotherapy for esophageal varices, 49 after a variceal bleeding episode (Group I) and 12 selected patients prophylactically (Group II). Mean follow-up was 12.6 months in Group I and 15.5 months in Group II. In Group I 27% died; only 10% of those patients presenting with mild liver disease (Child's Group A) who were followed died of gastrointestinal hemorrhage; but all presenting with severe liver disease (Child's Group C) died after a mean of 6.3 months, 57% following rebleeding. No patients in Group II died from esophageal hemorrhage. The rebleeding risk per patient-month of follow-up was 0.04 in Group I, 0.005 in Group II and 0.01 in the 22% of patients in Group I who achieved complete ablation of their varices. There was no mortality attributable to the procedure, and complications occurred after only 4.5% of the procedures; all were reversible. Sclerotherapy seems at present the treatment of choice for bleeding esophageal varices, considering its efficacy, safety and simplicity. It is probably also of value prophylactically in selected patients.